In Search of the Ninth Discipline: The History of Pathophysiology, with an Emphasis on Pathophysiology in Varna, Bulgaria—Celebrating 100 Years of Pathophysiology in Bulgaria

Pathophysiology is a medical science whose subject is the change in regulatory mechanisms related to the onset, development, and outcome of diseases. The first lectures on pathophysiology were held in 1790 at the University of Erfurt, Germany, by Professor Augustus Hecker, who in 1791 also published the first work on the discipline – "Grundriss der Physiologia pathologica" in 770 pages. The teaching of pathophysiology as an independent discipline was introduced by academician Viktor Pashutin at the University of Kazan, Russia in 1874. Academician Pashutin called this new discipline “Pathological Physiology and Experimental Medicine.” Despite the persuasiveness of Pashutin that pathological anatomy and pathophysiology are inseparable parts of a whole, his students, academician Nikolay Anichkov and Prof. Semyon Khalatov, implemented the so-called “divorce” due to the different, though complementary, approaches and methodologies of the two ideological fields. By Royal Decree on November 29, 1917, in the Bulgarian State Gazette, amendments were published in the law on the national education, which introduced new university “disciplines and departments”. Under number nine in the law is the discipline of “Pathological Physiology and Experimental Medicine”. Due to various factors, the Pathological Physiology and Experimental Medicine department was the only one of the first 25 departments not to be established. The beginning of the training for pathophysiology in Bulgaria was laid by Prof. Vassil Mollov and Assoc. Prof. Minko Dobrev, however due to their untimely deaths, the course lasted only three years (1936–1939) and was not continued in the next academic year. At the beginning of the academic year 1946/47, two assistants in pathophysiology were enrolled in the Department of Pathological Anatomy at Sofia University. The following year a separate department was formed at the newly founded Plovdiv University and shortly after at Sofia University. For the 100 years since its legislative establishment, 82 years since its unofficial start and 71 years since its academic establishment pathophysiology in Bulgaria has distinguished itself by scientific, administrative and clinical contributions. In its 57 years in Varna, Bulgaria pathophysiology has widely carried out that tradition with immense contributions.